Quteineh Mohammad, Obeid Sajedah N, Al-Shami Khayry, Hanifa Hamdah
Department of Clinical Medical Sciences, Faculty of Medicine Yarmouk University Irbid Jordan.
Faculty of Medicine University of Kalamoon Al-Nabk Syria.
Clin Case Rep. 2024 Feb 22;12(2):e8550. doi: 10.1002/ccr3.8550. eCollection 2024 Feb.
This case highlights the need for further research to explore a potential link between systemic sclerosis and fistula development, and the importance of raising awareness among clinicians about this possibility for timely appropriate management.
The primary diagnosis in this case is systemic sclerosis (scleroderma) in a 47-year-old female patient with various clinical manifestations, including vesicovaginal and vesicorectal fistulas. The medical interventions and diagnostic workup involved an electrocardiogram, cardiac echocardiogram, pulmonary function tests, beta blockers, aspirin, inhaled corticosteroids, albuterol, endoscopy, biopsy, treatment for infection, fluconazole for candida esophagitis, endoscopic dilation for achalasia, anticholinergic therapy for mixed urinary incontinence, gabapentin for neuropathic symptoms, analgesia for knee pain, and psychiatric treatment with selective serotonin reuptake inhibitors. The outcomes described in the case report include the diagnosis of systemic sclerosis, the identification of vesicovaginal and vesicorectal fistulas, the patient's medical history and symptoms over the years, and various treatments and management strategies.
该病例凸显了进一步开展研究以探索系统性硬化症与瘘管形成之间潜在联系的必要性,以及提高临床医生对这种可能性的认识以便及时进行恰当管理的重要性。
该病例的主要诊断为一名47岁女性患者患有系统性硬化症(硬皮病),伴有多种临床表现,包括膀胱阴道瘘和膀胱直肠瘘。医疗干预和诊断检查包括心电图、心脏超声心动图、肺功能测试、β受体阻滞剂、阿司匹林、吸入性糖皮质激素、沙丁胺醇、内镜检查、活检、抗感染治疗、氟康唑治疗念珠菌性食管炎、内镜扩张治疗贲门失弛缓症、抗胆碱能疗法治疗混合性尿失禁、加巴喷丁治疗神经病变症状、膝关节疼痛镇痛以及使用选择性5-羟色胺再摄取抑制剂进行精神治疗。病例报告中描述的结果包括系统性硬化症的诊断、膀胱阴道瘘和膀胱直肠瘘的识别、患者多年来的病史和症状,以及各种治疗和管理策略。